Citation

Lindner R. Forum der Psychoanalyse 2020; 36(2): 149-161.

Copyright

(Copyright © 2020)

DOI

10.1007/s00451-020-00394-6

PMID

unavailable

Abstract

In Western countries suicide rates among older and very old, particularly male, persons are high. The supply and use of psychotherapeutic treatments and facilities are low. Against this background, the intrapsychic dynamics and psychosocial conditions of suicidal older persons were investigated. On the basis of 30 in-depth interviews, ideal-typical constellations of suicidal elderly persons were formed concerning their behavior in using offers of help and their relationship formation. A semi-structured interview on the inner world and current life situation of older persons was developed and evaluated. Subsequently, very old suicidal multimorbid patients of a geriatric clinic were examined. The ideal types of suicidal elderly, who do not wish to undergo treatment, represent multi-determined forms of psychosocial retreat that maintain and promote suicidal tendencies, which leads to negative countertransference reactions that make it difficult to take up psychotherapy. In the study of geriatric patients, the suicidal individuals differed significantly from the controls in terms of more severe depression and more frequent psychiatric treatments during lifetime. Acutely experienced suicidality was more often triggered by a severe physical illness compared to those in the course of life, followed by interpersonal conflicts. The patients expressed the wish to talk about their suicidality with relatives rather than with professionals. In addition, specific aspects of suicidality in old age were investigated qualitatively and in case reports. The results were used to develop concepts for treatment offers and suicide prevention. © 2020, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

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